A few weeks ago, I expressed my frustration with our capital budget process . While I was gone, my coworkers submitted a request for, among others things, a stand lift transfer device. To say I was shocked was an understatement. Since that time I've campaigned Read More...

No, I'm not the one using a wheelchair. One of my fellow therapists is. She has chronic knee and ankle problems. It started out as wearing a walking boot, then progressed to a knee brace and either a walker or a wheelchair to get around. She chose the Read More...

I'm noticing a disturbing trend. I'm always the one pointing out the bad news. I admit I do better with realistic than cheerfully optimistic, but it seems like it's always me pointing out the flaw with a plan. If I'm not pointing out the obvious, I'm Read More...

This morning I was working on discharge planning with one of our case managers. A doctor was ready to discharge a patient and she had asked me for recommendations. I immediately said SNF. He wasn't able to safely transfer out of bed. I had yet to see Read More...

A few weeks ago, a woman was admitted to our facility with a knee injury. She appeared to have ligamentous damage on top of arthritic deformities. She came to us for medical management and antibiotics prior to surgery. Before she was admitted, her orthopedist Read More...

Last weekend I was describing a difficult patient I had worked with earlier in the month. It was someone with several chronic and out-of-control problems, obesity and medical noncompliance. I summarized my statement with, "I don't feel sorry for him. Read More...

I always enjoy talking to the therapists who come to my course. Last week I met a PT I'll call Dottie. I don't want to use her real name, but she reminds me of someone named Dottie. Dottie has been a therapist since back in the day. She graduated years Read More...

Driving home from work today, I was listening to a podcast of a morning radio show. They were making fun of a man who had been given some awards because he had been contributing regularly to the organizations. Because it's a local show, I knew who they Read More...

I spent last weekend at a horse show in San Antonio. Even though I had both show horses with me, there was still a lot of down time. Since everything is close quarters it's easy to overhear conversations. While I was waiting I was surprised to hear someone Read More...

Let me clarify that statement before I go any further. I refer to performing PROM as the only treatment on patients who are sedated, minimally responsive, have significant neurological involvement and the like. I'm not referring to outpatient settings, Read More...

In previous posts, I've discussed staffing issues where I work. Those problems continue. So does the return of the frequent flyer. Now we have something even more troubling. Our census continues to drop. The facility is at one-tenth of its capacity. There Read More...

Until recently, I had never worked closely with PM & R (physical medicine & rehabilitation) physicians. When I worked at the "evil empire," I dealt exclusively with neurologists. Some were good. Some weren't so good. Either way, their purpose Read More...

In recent posts, fellow ADVANCE bloggers Dean and Michael have been discussing how companies cut staff as a measure to lower costs. Neither of them supports the idea. Both make valid arguments against the practice that I'm sure would fall on deaf ears. Read More...

Last Saturday, one of my patients at the SNF was a woman with left femoral neck and humeral shaft fractures. She'd undergone an ORIF to repair the hip and the arm was immobilized. She was NWB on both extremities. Like many of our patients, this was not Read More...

I had a good laugh this morning. A doctor was ranting and raving that an order he'd written two weeks ago still hadn't been followed. The order was for a pressure-relieving shoe for a patient with a plantar wound. The doctor was very upset. He was making Read More...